Oral Herpes???

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So my friend has them and was wondering since technically there is no cure for them, if it's safe to go down on her boyfriend.....i told her sure because it's a somewhat different virus than HPV (Herpes Simplex Virus)....anyways, just wanted to post the question on a more serious and well informed group than the juvenile filled 'lounge'.....and i think she has type I?!?

 

[DOtobe]

I believe that type I can cause both oral and genital herpes.

So I'd say she'd better wait for a few days.

 

[Smurfette]

Somewhere, safe sex educators and college health service personnel are shaking their heads in disappointment.

Type I and type II can BOTH cause either oral or genital herpes. You can get genital herpes from cold sores and vice versa. Whether it's type 1 or type 2 is not relevant, they both are easily transmittable. You need to abstain or use protection if someone has cold sores or genital sores.

Once upon a time, type 1 was 'oral' and 2 was 'genital'. Now it is more mixed (and where I'm from, this is actually reversed, and more people with genital herpes have type 1 HSV). ID experts blame the "oral sex isn't sex" belief that has recently become popular opinion.

BTW, HPV=human papilloma virus, which causes genital warts and cervical cancer, etc. HSV=herpes simplex virus, which causes cold sores and genital herpes.

smurfette

 

[VentdependenT]

99% of the human population has HSV I. Ever get stressed out and bust out a sore in your mouth.....you got herpes. So does your dad and mom and brother......

 

[DrQuinn]

You know I've never had a cold sore... EVER, in my entire life. Weird since I've gone down on quite a handful of genitalia (none with frank STDs).

I'm surprised I've gone through life without an STD...


Q, DO

 

[ortho2003]

is quite a handful referring to girth or number???

 

[cache20033]

i assume QuinnNSU is referring to a number considering he's a man....unless of course he leads the alternative lifestyle which is still cool if he's that way...


p.s. you know QuinnNSU, you really need to change your avatar because you really are confusing a lot of the people on this board with that random picture...i wouldn't be surprised if there was an increase of ER residency applications at your program due to this..jk! (anways, you'd be dissappointing a lot of people when they find out.....i think also you've disappointed a lot of SDN'ers now that your secret is out..funny how i always laugh at those guys flirting with you...too funny!!)

 

[ckent]

I second that request for Quinn to change his avatar. There is no cure for HSV, but if things get too out of hand, there are anti-viral medications that one can take in order to supress recurrences. Things like stress can also make the illness worse. I could be mistaken, but I vaguely recall someone saying that HSV was not contagious unless you can see active lesions. I wouldn't go out and act on that though, since it's only something that I vaguely recall. And while it's true that the vast majority of people have been exposed to HSV-1, nobody knows why only certain people develop cold sores.

 

[Weeble]

Originally posted by ckent
but I vaguely recall someone saying that HSV was not contagious unless you can see active lesions.

We were taught that something like 2/3 of herpes infections are from asymptomatic viral shedding, ie. no frank lesions. Scary.

 

[tussy]

don't take it lightly. Herpes can make you very very sick. i got oral herpes, which progressed to meningitis. I ended up in the hospital for a week - scary.

 

[Su4n2]

ok guys,

i don't get it. i get cold sores when i stress, so does my mom, grandma, etc. i did when i was a kid too. i have never had the type of contact that would give me genital herpes. wtf? how can it be the same thing? please enlighten. should i be worried?

 

[pmichaelmd]

Same virus, different strain. As said above, type 1 used to be considered "oral" and type 2 "genital." One can get either in either location. This occurs most readily when open sores are shedding virus and you come into contact with these virions, especially on a mucosal surface. As a virus, you never truly get rid of it. The virus gets activated by stress, trauma (ie cut on the mucosa), sun damage, you name it. Once it runs its course, typically up to several weeks, it recesses to the dorsal root ganglia and hides out, waiting to spring forth once more.

If you got it as a child, it's likely that you got it from salivary transfer from your mum or other infected adult. I believe the overall seroprevalence of HSV-1 in Western adults is something like 85-90% by the age of 30 and there is a rise in the seroprevalence of HSV-2 in a similar fashion, something around 30%... can't remember exactly at this moment. Probably increasing because people do shed virus even when asymptomatic.

Bottom line: You can get either strain on or in your mouth/oropharynx/genitals. Just be careful.

 

[Larry Renal]

Just help me clarify here. I feel like my non-med school friends are always asking me about this and I can never give a good answer. The seroprevalence of HSV I is about 90%. Since that's in serum and not localized in the mouth, why are most outbreaks in the mouth? Is it possible for a stressful event to cause the expression of genital lesions of HSV I? If this is such a huge risk (ie. 2/3 of transmissions are during asymptomatic viral shedding) why isn't there a seemingly higher number of cases of genital herpes in otherwise "virgins?" Is HSV II any more or less virulent than HSV I? Finally, where's the public education on this issue? Phew, that should keep y'all busy for a while.

 

[DrQuinn]

The virus stays latent in the neural tissue, much like Varicella.

And I once did propose to change my avatar, but I was quickly accosted, and told to leave it, as it is part of SDN "history."

Q, DO

 

[omores]

Larry:

As QuinnNSU points out, the virus hangs out in nerve cells. Most of the time it's deep within them, minding its own business, but in response to triggers such as sunlight, hormonal shifts and stress, it gets reactivated and causes lesions at the surfact of the skin.

The "seropostive" refers to HSV antibodies, which are circulating in your blood -- not to the virus itself.

 

[shigaT]

Originally posted by Su4n2
ok guys,

i don't get it. i get cold sores when i stress, so does my mom, grandma, etc. i did when i was a kid too. i have never had the type of contact that would give me genital herpes. wtf? how can it be the same thing? please enlighten. should i be worried?

you probably have familial apthous ulcers - cause is unknown but believed to be autoimmune in nature. unforntunately the treatment is primarily targeted toward pain relief. occasionally a short course of oral steroids will be used for bad cases.

 

[Voxel]

Would you really bet your genitals on that assumption? Do not give out a diagnosis over the internet to people whom you have not done a proper work up including history and physical and any lab or imaging tests necessary.

 

[Sessamoid]

Originally posted by shigaT
you probably have familial apthous ulcers - cause is unknown but believed to be autoimmune in nature. unforntunately the treatment is primarily targeted toward pain relief. occasionally a short course of oral steroids will be used for bad cases.

I've run through several phases where I get apthous ulcers in my life, usually during periods of high stress. As shigaT noted, the cause is unclear, though many have been posited. It's pretty clearly not herpes simplex of any type.

For apthous ulcers, the magic solution I've found was triamcinolone dental paste (1% I think). It's a reallly thick, sticky, grainy paste which sticks pretty well even when wet (sticks to teeth and fingers too). It kills the pain almost instantaneously and seems to speed along the healing process. I wouldn't recommend this for cold sores though, since that's clearly viral.

On apthous ulcers, there's almost no literature on this ailment since it's completely benign (aside from the pain) and self-resolving.

 

[Thewonderer]

Originally posted by ckent
And while it's true that the vast majority of people have been exposed to HSV-1, nobody knows why only certain people develop cold sores.

agree. most people have HSV. a small proportion of these people never develop cold sores (i.e. sx's) but they can still shed the virus and transmit it. If you have kissed many many fellow human beings, most likely you have HSV.

 

[Thewonderer]

Originally posted by Larry Renal
If this is such a huge risk (ie. 2/3 of transmissions are during asymptomatic viral shedding) why isn't there a seemingly higher number of cases of genital herpes in otherwise "virgins?" Is HSV II any more or less virulent than HSV I?

from somewhere in the back of my memory, I remember that HSV I has a higher affinity for oral mucosa while HSV II higher affinity for genital mucosa. Therefore, during oral sex, the probability of trasmitting HSV I from the mouth to the genital region is smaller than the probabily of transmitting HSV II between genital parts.

don't quote me on that though. I just vaguely remember from some where.....

 

[cbc]

Do HSV1 on genitals hurt? So if one has latent HSV1, when can you know for sure you can go down on another? Sometimes those oral cold sores slowly creeps up.